Crack aiims/ neet-pg 2017: medicine mcqs 261-280

Q-261. All of the following are the known cause of osteoporosis except
a) Fluorosis
b) Hypogonadism
c) Hyperthyroidism
d) Hyperparathyroidism

Answer: Fluorosis
Explanation:
Fluorosis is not associated with osteoporosis but associated with osteo-sclerosis.
Osteoporosis and endocrine disorders:
Hyperthyroidism
Thyrotoxicosis
Hyperparathyroidism
DM type II
Adrenal insufficiency
Acromegaly, Cushing’s syndrome
Hypo-gonadal states

Q-262. Which of the following is not a feature of hyper-calcemia?
a) Diarrhea
b) Polyuria
c) Depression
d) Vomiting

Answer: Diarrhea
Explanation:
Features of hyper-calcemia:
Anorexia
Nausea
Vomiting
Pain abdomen
Polyuria and nocturia
Depression
Mental confusion
ECG findings: Short QT interval

Q-263. The most common location of hypertensive intracranial hemorrhage is:
a) Subarachnoid space
b) Basal ganglia
c) Cerebellum
d) Hypertension

Answer: Basal ganglia
Explanation:
Site of hemorrhage or lesion: Abnormal movement
Caudate and putamen: Chorea
Globus pallidus (Lentiform nucleus): Athetosis
Substantia nigra: Parkinsonism
Sub-thalamic nuclei: Hemi-ballismus (Flinging movement of a proximal limb)
Important points:
The putamen/ basal ganglia are the most common site for hypertensive hemorrhage.

Q-264. The common cause of subarachnoid hemorrhage is
a) Arterio- venous malformation
b) Cavernous angioma
c) Aneurysm
d) Hypertension

Answer: Aneurysm
Explanation:
The most common cause of subarachnoid hemorrhage is rupture os saccular aneurysm, Berry aneurysm and most commonly occur in the anterior circulation on the circle of the Willis (Excluding head trauma).

Q-265. Which one of the following agents has been associated with hemorrhagic stroke?
a) Phenyl-propanolamine
b) Terfenadine
c) Quinidine
d) Fenfluramine

Answer: Phenyl-propanolamine
Explanation:
Phenyl-propanolamine:
Similar to ephedrine
Used in oral decongestant combination remedies
Used for weight loss as appetitic suppressant.
Its use is associated with hemorrhagic stroke.

Q-266. Which of the following is the most common type of glial tumors?
a) Astrocytoma
b) Medulloblastoma
c) Neurofibroma
d) Ependymoma

Answer: Astrocytoma
Explanation:
Astrocytoma is the most common primary intra-cranial neoplasm.

Q-267. Brain abscess in cyanotic heart disease is commonly located in
a) Cerebellar hemisphere
b) Thalamus
c) Temporal lobe
d) Parietal lobe

Answer: Parietal lobe
Explanation:
Brain abscess associated with congenital heart disease:
The abscesses are located in the parietal, frontal, and temporal lobes.
Parietal and frontal lobe are most common sites because of middle cerebral artery embolization in congenital heart disease.

Q-268. Which one of the following clinical findings excludes the diagnosis of Polymyositis?
a) Neck muscle involvement
b) Extra-ocular muscle involvement
c) Dysphagia
d) Abdominal muscle involvement

Answer: Extra-ocular muscle involvement
Explanation:
Extra-ocular muscle and facial muscle involvement exclude the diagnosis of Polymyositis.

Q-269. A young girl has consumed barium carbonate with suicidal intent. She complains of generalized muscle weakness. The most likely electrolyte is
a) Hypo-natremia
b) Hypo-calcemia
c) Hypo-kalemia
d) Hypo-magnesemia

Answer: Hypo-kalemia
Explanation:
Barium carbonate ingestion results into hypo-kalemia due to large shift of extra-cellular potassium into muscle.

Q-270. All of the following statements regarding primary effusion lymphoma are true except
a) It generally presents in elderly patients
b) There is often an association with HHV-8
c) The proliferating cells are NK cells
d) Patients are commonly HIV positive

Answer: The proliferating cells are NK cells
Explanation:
Primary effusion lymphoma is rare subtype of diffuse large B-cell lymphoma.
Primary effusion lymphoma may also be called body cavity lymphoma.
Primary effusion lymphoma is linked to human herpes virus 8 (HHV8) infections. It is also associated with Epstein-Barr virus (EBV) infection in many cases.
Primary effusion lymphoma most often occurs in people with weakened immune systems, such as those with HIV/AIDS.

Q-271. A patient with leukemia on chemotherapy develops acute right lower abdominal pain associated with anemia, thrombocytopenia and leucopenia. Which of following is the clinical diagnosis?
a) Appendicitis
b) Leukemic colitis
c) Perforation peritonitis
d) Neutropenic colitis

Answer: Neutropenic colitis
Explanation:
Neutropenic entero-colitis, also known as typhlitis is an acute life-threatening condition classically characterized by trans-mural inflammation of the caecum, often with involvement of the ascending colon and ileum, in patients who are severely myelo-suppressed.
Most patients who are affected with neutropenic entero-colitis are receiving anti-neoplastic drugs and are profoundly neutropenic.
Symptoms include the following:
Right lower quadrant abdominal pain, which may be cramping and intermittent or a continuous dull ache
Fever
Watery or bloody diarrhea
Nausea
Vomiting
Abdominal distention

Q-272. All of the following are major complications of massive transfusion except
a) Hypokalemia
b) Hypothermia
c) Hypo-magnesemia
d) Hypo-calcemia

Answer: Hypokalemia
Explanation:
Major complications of massive transfusion:
Hyperkalemia
Hypo-calcemia
Hypo-magnesemia
Acidosis
Hypothermia
Fluid overload
Decreased 2, 3 DPG

Q-273. All of the following are risk factors for atherosclerosis except
a) Increased waist-hip ratio
b) Hyper-Homocystinemia
c) Decreased fibrinogen levels
d) Decreased HDL levels

Answer: Decreased fibrinogen levels
Explanation:
Increased level of fibrinogen is associated with increased risk of atherosclerosis.

Q-274. All of the following may occur due to hyper-kalemia, except:
a) Prolonged PR interval
b) Prolonged QRS interval
c) Prolonged QT interval
d) Ventricular asystole

Answer: Prolonged QT interval
Explanation:
ECG findings in hyper-kalemia:
Prolonged PR interval
Prolonged QRS interval
Ventricular asystole

Q-275. All of the following may be seen in patients of cardiac tamponade except
a) Kussmaul’s sign
b) Pulsus paradoxus
c) Electrical Alternans
d) Right ventricular diastolic collapse on echocardiogram

Answer: Kussmaul’s sign
Explanation:

Q-276. All of the following are true for mitral valve prolapse except
a) Transmission may be as an autosomal dominant trait
b) Majority of cases present with features of mitral regurgitation
c) The value leaflets characteristically show Myxomatous degeneration
d) The disease is one of the common cardiovascular manifestations of Marfan’s syndrome

Answer: Majority of cases present with features of mitral regurgitation
Explanation:
Mitral valves prolapse:
Floppy or Myxomatous mitral valve
Associated with skeletal deformities (Pectus excavatum, scoliosis) and systemic collagen abnormality (Marfan or Ehlers Danlos syndrome)
Most patients are female.
Single or multiple mid-systolic clicks and pansystolic or late systolic murmur
Echocardiography is confirmatory.

Q-277. Sudden cardiac death may occur in all of the following except
a) Dilated cardiomyopathy
b) Hypertrophic cardiomyopathy
c) Eisenmenger’s syndrome
d) Ventricular septal defect

Answer: Ventricular septal defect
Explanation:
Causes of sudden cardiac death:
Coronary artery disease
Dilated cardiomyopathy
Hypertrophic cardiomyopathy
Valvular disease
Long QT syndrome
Ventricular arrhythmia- Eisenmenger’s syndrome
Heart failure
Shock
Electrolyte imbalance (Hypo-kalemia)
Hypoxia

Q-278. Which of the following is least likely to cause infective endocarditis?
a) Staphylococcus albus
b) Streptococcus fecalis
c) Salmonella typhi
d) Pseudomonas aeruginosa

Answer: Salmonella typhi
Explanation:
Causes of infective endocarditis:
Staphylococcus albus- Prosthetic valve endocarditis
Streptococcus fecalis- Most common cause of entero-coccal infective endocarditis
Pseudomonas aeruginosa- Infective endocarditis in drug users

Q-279. Mycotic aneurysm is an aneurysm infected because of
a) Fungal infection
b) Blood- borne infection (intra-vascular)
c) Infection introduced from outside (extra-vascular)
d) Both intravascular and extra-vascular infection

Answer: Both intravascular and extra-vascular infection
Explanation:
Mycotic aneurysms are an aneurysm arising from infection of the arterial wall, usually bacterial.
Origin of infections:
Intra-vascular
Extra-vascular
Primary or cryptogenic origin
Important points:
Osler first used the term “mycotic aneurysm” in 1885 to describe a mushroom-shaped aneurysm in a patient with sub-acute bacterial endocarditis.
This may create considerable confusion, since “mycotic” is typically used to define fungal infections.

Q-280. Mycotic abscesses are due to
a) Bacterial infection
b) Fungal infection
c) Viral infection
d) Mixed infection

Answer: Fungal infection
Explanation:
Mycotic abscess is characterized by a soft, cystic mass without or with mild inflammation caused by fungal infections.